Newswise — Lifestyle choices are pieces of the cancer prevention puzzle, but exactly which steps to take remain unclear, even to scientists. Still, more and more individuals are incorporating small changes into their daily routine — such as drinking green tea — in hopes of keeping cancer risk at bay.

Is it working? A large new Cochrane review of studies that examined the affect of green tea on cancer prevention has yielded conflicting results.

Researchers looked at 51 medium- to high-quality studies that included more than 1.6 million participants. The studies focused on the relationship between green tea consumption and a variety of cancers, including breast, lung, digestive tract, urological prostate, gynecological and oral cancers.

The comprehensive review analyzed studies conducted from 1985 through 2008. Many of the reviewed studies took place in Asia, where tea drinking is widespread and part of the daily routine for many.

The review appears in the latest issue of The Cochrane Library, which is a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.

"Despite the large number of included studies the jury still seems to be out on the question of whether green tea can in fact prevent the development of various cancer types," said lead review author Katja Boehm, Ph.D. Since people drink varying amounts of green tea, and different types of cancers vary in how they grow, it is impossible to state definitively that green tea is "good" for cancer prevention.

"One thing is certain"¦green tea consumption can never account for cancer prevention alone," said Boehm, a member of the Unconventional and Complementary Methods in Oncology Study Group in Nuremburg, Germany.

Three types of tea — black, green and oolong — come from the plant Camellia sinensis, and all contain polyphenols. Catechins, a subgroup of the polyphenols, are powerful antioxidants. Some say the polyphenols in green tea are unique, preventing cell growth and thus having the potential to prevent cancer.

The review found that green tea had limited benefits for liver cancer, but found conflicting evidence for other gastrointestinal cancers, such as cancer of the esophagus, colon or pancreas. One study found a decreased risk of prostate cancer for men who consumed higher quantities of green tea or its extracts.

The review did not find any benefit for preventing death from gastric cancer, and found that green tea might even increase the risk of urinary bladder cancer. Despite conflicting findings, there was "limited moderate to strong evidence" of a benefit for lung, pancreatic and colorectal cancer. None of the studies that simply observed a group of people over time found a benefit for breast cancer prevention. However, both of the case control studies — which compare people without a condition to people with it — found a positive association between green tea consumption and a decreased risk of breast cancer.

Nagi Kumar, Ph.D., director of Nutrition Research at Moffitt Cancer Center in Tampa, Fla., is optimistic about the potential for green tea in cancer prevention. "The substances found in green tea are certainly promising," Kumar said. "The field now has progressed to where we [can]"¦test the effectiveness and safety of green tea polyphenols using a drug form similar to the constituents in tea to see if we can prevent cancer progression. Time will tell."

Kumar said the Cochrane review was "more an inventory of studies completed rather than a systematic scientific review," adding that "the discussion lacks a scientific approach in the interpretation of the discordant findings."

Kumar also noted that several groups are conducting randomized clinical trials, including one comprising six institutions: the Moffitt Cancer Center and the James A Haley VA Medical Center, University of Chicago, Jefferson in Philadelphia, University of Florida and Louisiana State University.

Both scientists agreed that more research is a good idea. Boehm said she highly recommends the conduction of a large, well-designed, study with adequate green tea consumption levels.

"The review provides where we have been in this field of research and where we are going and how much more we have on hand," Kumar said. "Although not as thorough as I would like it, it is a good quality review."

Therefore, while the questions about green tea consumption and cancer prevention remain unanswered, one thing remains clear: It is fine to consume green tea if you enjoy it and it might prove beneficial in the over time.

"If not exceeding the daily recommended allowance those who enjoy a cup of green tea should continue its consumption," Boehm said. "Drinking green tea appears to be safe at regular, habitual and moderate use at its recommended dosage of up to 1200 ml/day." That comes to a little over five cups a day.

The Cochrane Collaboration is an international nonprofit, independent organization that produces and disseminates systematic reviews of health care interventions and promotes the search for evidence in the form of clinical trials and other studies of interventions. Visit for more information.

Boehm K, et al. Green tea (Camellia sinensis) for the prevention of cancer. Cochrane Database of Systematic Reviews Issue 3, 2009.

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